Antimicrobial susceptibility pattern of aerobic bacteria responsible for post-surgical wound infection of the patients admitted into Khulna Medical College Hospital, Bangladesh.

Resistance against antimicrobial agents is dramatically increasing and gradually impacting treatment costs. Using existing drugs would have helped avoid bacterial infections in various circumstances. The primary objectives of this study were to determine the prevalence of pathogens responsible for postsurgical wound infections and their antimicrobial susceptibility and resistance pattern among the patients admitted to Khulna Medical College Hospital, Khulna Bangladesh. This cross-sectional study involved 250 patients suffering from postsurgical wound infection as respondents. The bacterial pathogens were isolated from pus samples obtained from those patients. The isolated bacterial pathogens were identified through several standard biochemical tests, and finally, the culture sensitivity tests of those bacterial isolates were performed. The study was conducted from August 2019 to June 2020. Data regarding the patient's age, gender, occupation, surgery performed, duration of hospital stay, and comorbidity were also documented using standard questionnaires. Five bacterial pathogens were identified with different frequencies, including Pseudomonas aeruginosa (36 %), Escherichia coli (21.2 %), Staphylococcus aureus (8.8 %), Klebsiella spp. (7.2 %) and Proteus spp. (4.8 %). These bacterial pathogens showed sensitivity to ciprofloxacin (75 %), piperacillin-tazobactam (56.7 %) and gentamicin (50 %). Besides, S. aureus showed sensitivity to linezolid and vancomycin and resistance to cefuroxime, ceftazidime and imipenem. Male patients (68.4 %) suffered more from postsurgical wound infection than female patients (31.6 %). Patients aged 31 to 40 years were more severely affected than patients from other age groups. Postsurgical wound infection was vigorously observed in the patients who underwent hand surgery. Intensive occurrence of this infection was found in the patients who stayed in the hospital from 31 to 40 days. Diabetic patients suffered more from postsurgical wound infection compared to the other patients. Throughout the study, ciprofloxacin has been the best performer against E. coli, Klebsiella spp., and Proteus spp., and gentamicin showed better performance against S. aureus. The antibiotic resistance pattern of these bacterial pathogens reflects the worldwide necessity of rational antibiotic management and proper steps to maintain hospital hygiene in Bangladesh.

Estimation of country-specific tuberculosis resistance antibiograms using pathogen genomics and machine learning.

BACKGROUND: Global tuberculosis (TB) drug resistance (DR) surveillance focuses on rifampicin. We examined the potential of public and surveillance Mycobacterium tuberculosis (Mtb) whole-genome sequencing (WGS) data, to generate expanded country-level resistance prevalence estimates (antibiograms) using in silico resistance prediction. METHODS: We curated and quality-controlled Mtb WGS data. We used a validated random forest model to predict phenotypic resistance to 12 drugs and bias-corrected for model performance, outbreak sampling and rifampicin resistance oversampling. Validation leveraged a national DR survey conducted in South Africa. RESULTS: Mtb isolates from 29 countries (n=19 149) met sequence quality criteria. Global marginal genotypic resistance among mono-resistant TB estimates overlapped with the South African DR survey, except for isoniazid, ethionamide and second-line injectables, which were underestimated (n=3134). Among multidrug resistant (MDR) TB (n=268), estimates overlapped for the fluoroquinolones but overestimated other drugs. Globally pooled mono-resistance to isoniazid was 10.9% (95% CI: 10.2-11.7%, n=14 012). Mono-levofloxacin resistance rates were highest in South Asia (Pakistan 3.4% (0.1-11%), n=111 and India 2.8% (0.08-9.4%), n=114). Given the recent interest in drugs enhancing ethionamide activity and their expected activity against isolates with resistance discordance between isoniazid and ethionamide, we measured this rate and found it to be high at 74.4% (IQR: 64.5-79.7%) of isoniazid-resistant isolates predicted to be ethionamide susceptible. The global susceptibility rate to pyrazinamide and levofloxacin among MDR was 15.1% (95% CI: 10.2-19.9%, n=3964). CONCLUSIONS: This is the first attempt at global Mtb antibiogram estimation. DR prevalence in Mtb can be reliably estimated using public WGS and phenotypic resistance prediction for key antibiotics, but public WGS data demonstrates oversampling of isolates with higher resistance levels than MDR. Nevertheless, our results raise concerns about the empiric use of short-course fluoroquinolone regimens for drug-susceptible TB in South Asia and indicate underutilisation of ethionamide in MDR treatment.

Enhancing breast cancer classification via histopathological image analysis: Leveraging self-supervised contrastive learning and transfer learning.

Breast cancer, a significant threat to women's health, demands early detection. Automating histopathological image analysis offers a promising solution to enhance efficiency and accuracy in diagnosis. This study addresses the challenge of breast cancer histopathological image classification by leveraging the ResNet architecture, known for its depth and skip connections. In this work, two distinct approaches were pursued, each driven by unique motivations. The first approach aimed to improve the learning process through self-supervised contrastive learning. It utilizes a small subset of the training data for initial model training and progressively expands the training set by incorporating confidently labeled data from the unlabeled pool, ultimately achieving a reliable model with limited training data. The second approach focused on optimizing the architecture by combining ResNet50 and Inception module to get a lightweight and efficient classifier. The dataset utilized in this work comprises histopathological images categorized into benign and malignant classes at varying magnification levels (40X, 100X, 200X, 400X), all originating from the same source image. The results demonstrate state-of-the-art performance, achieving 98% accuracy for images magnified at 40X and 200X, and 94% for 100X and 400X. Notably, the proposed architecture boasts a substantially reduced parameter count of approximately 3.6 million, contrasting with existing leading architectures, which possess parameter sizes at least twice as large.

Preparation, characterization, and adsorption kinetics of graphene oxide/chitosan/carboxymethyl cellulose composites for the removal of environmentally relevant toxic metals.

This study attempted to develop a low-cost and eco-friendly bio-based composite adsorbent that is highly efficient in capturing potential toxic metals. The bio-composite adsorbent was prepared using graphene oxide (GO), carboxymethyl cellulose (CMC) and chitosan (CS); and characterized using FTIR, SEM-EDX and WAXD techniques. Metal-ion concentration in an aqueous solution was measured by ICP-OES. This article reveals that the adsorption of heavy metal ions varied according to the adsorbent quantity, initial metal concentration, pH, and interaction time. The metal ions' adsorption capacity (mg/g) was observed to increase when the interaction time and metal concentration increased. Conversely, metal ions adsorption was decreased with an increase in adsorbent dosages. The effect of pH on metal ions' adsorption was ion-specific. The substantial adsorption by GO/CMC/CS composite for Co2+, CrO42-, Mn2+ and Cd2+, had the respective values of 43.55, 77.70, 57.78, and 91.38 mg/g under acidic conditions. The metal ions experimental data were best fitted with pseudo-second-order (PSO) kinetics, and Freundlich isotherm model (except Co2+). The separation factors (RL) value in the present investigation were found between 0 and 1, meaning that the metal ions adsorption onto GO/CS/CMC composite is favorable. The RL and sorption intensity (1/n) values fitted well to the adsorption isotherm.

Neuronal NADPH oxidase is required for neurite regeneration of Aplysia bag cell neurons.

NADPH oxidase (Nox), a major source of reactive oxygen species (ROS), is involved in neurodegeneration after injury and disease. Nox is expressed in both neuronal and non-neuronal cells and contributes to an elevated ROS level after injury. Contrary to the well-known damaging effect of Nox-derived ROS in neurodegeneration, recently a physiological role of Nox in nervous system development including neurogenesis, neuronal polarity, and axonal growth has been revealed. Here, we tested a role for neuronal Nox in neurite regeneration following mechanical transection in cultured Aplysia bag cell neurons. Using a novel hydrogen peroxide (H2 O2 )-sensing dye, 5'-(p-borophenyl)-2'-pyridylthiazole pinacol ester (BPPT), we found that H2 O2 levels are elevated in regenerating growth cones following injury. Redistribution of Nox2 and p40phox in the growth cone central domain suggests Nox2 activation after injury. Inhibiting Nox with the pan-Nox inhibitor celastrol reduced neurite regeneration rate. Pharmacological inhibition of Nox is correlated with reduced activation of Src2 tyrosine kinase and F-actin content in the growth cone. Taken together, these findings suggest that Nox-derived ROS regulate neurite regeneration following injury through Src2-mediated regulation of actin organization in Aplysia growth cones.

The symmetric and asymmetric effects of climate change on rice productivity in Malaysia.

The current study aims to examine the symmetric and asymmetric effects of climate change (CC) on rice productivity (RP) in Malaysia. The Autoregressive-Distributed Lag (ARDL) and Non-linear Autoregressive Distributed Lag (NARDL) models were employed in this study. Time series data from 1980 to 2019 were collected from the World Bank and the Department of Statistics, Malaysia. The estimated results are also validated using Fully Modified Ordinary Least Squares (FMOLS), Dynamic Ordinary Least Squares (DOLS), and Canonical Cointegration Regression (CCR). The findings of symmetric ARDL show that rainfall and cultivated area have significant and advantageous effects on rice output. The NARDL-bound test outcomes display that climate change has an asymmetrical long-run impact on rice productivity. Climate change has had varying degrees of positive and negative impacts on rice productivity in Malaysia. Positive changes in temperature and rainfall have a substantial and destructive impact on RP. At the same time, negative variations in temperature and rainfall have a substantial and positive impact on rice production in the Malaysian agriculture sector. Changes in cultivated areas, both positive and negative, have a long-term optimistic impact on rice output. Additionally, we discovered that only temperature affects rice output in both directions. Malaysian policymakers must understand the symmetric and asymmetric effects of CC on RP and agricultural policies that will promote sustainable agricultural development and food security.

Surface water quality for irrigation and industrial purposes: a comparison between the south and north sides of the Wei River Plain (northwest China).

Surface water is extensively used for irrigation and industrial purposes in the Wei River Plain. However, the surface water shows different characteristics in the southern and northern zones of the Wei River Plain. This study aims to investigate the differences in surface water quality between the southern and northern zones of the Wei River Plain and their influencing factors. To ascertain the hydrochemistry and its governing factors, graphical methods, ion plots, and multivariate statistical analyses were employed. The quality of the irrigation water was assessed using various irrigation water quality indices. In addition, water foaming, corrosion, scaling, and incrustation risks were determined to evaluate water quality for industrial uses. The spatial distribution of water quality was done using GIS models. This research revealed that the concentrations of EC, TH, TDS, HCO3-, Na+, Mg2+, SO42- and Cl- on the north side of the plain were twice as high as those on the south side. On both sides of the Wei River Plain, water‒rock interactions, ion exchange, and considerable evaporation were observed. Gypsum, halite, calcite, and dolomite all dissolve to produce significant anions and cations in the water, according to ion correlation analysis. However, additional sources of contaminants led to higher concentrations in the surface water on the north side than on the south side. Surface water in the south of the Wei River Plain has superior quality to that in the north, according to the overall findings of irrigation water and industrial water quality assessments. The findings of this study will boost better water resource management policies for the plain.

Urosepsis and Bacteriuria in Patients Undergoing TRUS-Guided Prostate Biopsy.

A prostate gland biopsy is a test to remove small sample of prostate tissue to be examined under a microscope. A biopsy may be done when a blood test shows a high level of prostate-specific antigen (PSA) or after a digital rectal examination finds an abnormal prostate or a lump. Transrectal ultrasound (TRUS) guided biopsy is a commonly performed procedure for the detection of prostate cancer. It is associated with serious complication like urosepsis. Although the incidence of post-TRUS urosepsis is low, when it occurs it is typically serious and leads to hospitalization. Antibiotics are used prior, during and after the procedure to prevent infections as a result of TRUS biopsy. Ciprofloxacin is being used as antibiotic of choice for a long time. Antibiotic prophylaxis may prevent such complications. This cross-sectional descriptive type of observational study was taken place in Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2010 to December 2011 among purposively selected 70 patients with an aim to determine the urosepsis and bacteriuria after TRUS guided prostate biopsy. Patients attending the Urology OPD in DMCH having of LUTS and other non-specific symptoms were evaluated by history, physical examination including digital rectal examination (DRE) and necessary investigations like serum PSA to identify the potential candidates. Patients with abnormal DRE findings and increased PSA level were included in this study and those who had any painful anal and rectal condition, bleeding diathesis, anticoagulant therapy and any known allergy to lidocaine, previously undergone prostrate biopsy and those who refused to give the informed consent were excluded from this study. Data were collected on variables of interest using a structured case record form. Data were processed and analyzed using Statistical package for social science (SPSS), version 17.0. Frequency of bacteriuria and urosepsis was measured according to urine and blood culture report. Sensitivity pattern was also seen. According to this study, the frequency of bacteriuria and urosepsis was 17.1% and 5.7% respectively. Most common uropathogen was E coli both in urine and blood culture. Organisms (100.0%) were found resistant to ciprofloxacin and amoxicillin. Most of the pathogens were sensitive to tobramycin, gentamycin and cefipime. A potentially dangerous ciprofloxacin resistant organism (ESBL producing E. coli) was found positive in 25.0% of culture positive patients.

Variation and multi-time series prediction of total hardness in groundwater of the Guanzhong Plain (China) using grey Markov model.

Total hardness (TH) is an important index representing the water suitability for domestic purpose. TH is represented mainly by Ca2+ and Mg2+ which are essential elements for human bone development. Between 2000 and 2015, the TH values of groundwater in major cities of the Guanzhong Plain varied significantly. The study was carried out to investigate TH variation over 16 years and to examine how effective the grey Markov model was in predicting TH concentrations in time series datasets. The hydrochemical parameters determining TH concentration and their origins were investigated using statistical analysis and geochemical models. The grey Markov model, which is effective in short time series prediction, was used to forecast the multi-time series of TH. The findings demonstrated a prevalence of HCO3- and SO42- in the groundwater types combined with calcite precipitation, gypsum, and dolomite dissolution that increased the concentration of Ca2+, Mg2+, and HCO3-, influencing TH variation. The predicted TH values of the eight monitoring wells for the year 2016 were 1213.66, 124.30, 203.66, 103.01, 349.56, 251.23, 453.31, and 471.81 mg/L, respectively. Datasets with low TH variation were more accurately predicted than datasets with high TH variation. This was especially observed on sample B557 where TH concentration in 2010 was 400.33 mg/L and suddenly dropped to 90.1, 82.6, 85.1, 87.6, and 75.1 mg/L in 2011, 2012, 2013, 2014, and 2015, respectively. The study also shows that the Markov chain model can optimize the GM(1,1) model and improve the prediction accuracy significantly. All samples in Weinan City and one sample in Xi'an City showed a significant decrease in TH concentration. Except one sample in Xi'an City, TH concentrations tended to rise in the other cities (Baoji, Xianyang) of the Guanzhong Plain. This study verified the reliability of the grey Markov model in terms of forecasting time series datasets with high variability, and the results can be referential to similar studies in the world.

A Critical Review on the Sensing, Control, and Manipulation of Single Molecules on Optofluidic Devices.

Single-molecule techniques have shifted the paradigm of biological measurements from ensemble measurements to probing individual molecules and propelled a rapid revolution in related fields. Compared to ensemble measurements of biomolecules, single-molecule techniques provide a breadth of information with a high spatial and temporal resolution at the molecular level. Usually, optical and electrical methods are two commonly employed methods for probing single molecules, and some platforms even offer the integration of these two methods such as optofluidics. The recent spark in technological advancement and the tremendous leap in fabrication techniques, microfluidics, and integrated optofluidics are paving the way toward low cost, chip-scale, portable, and point-of-care diagnostic and single-molecule analysis tools. This review provides the fundamentals and overview of commonly employed single-molecule methods including optical methods, electrical methods, force-based methods, combinatorial integrated methods, etc. In most single-molecule experiments, the ability to manipulate and exercise precise control over individual molecules plays a vital role, which sometimes defines the capabilities and limits of the operation. This review discusses different manipulation techniques including sorting and trapping individual particles. An insight into the control of single molecules is provided that mainly discusses the recent development of electrical control over single molecules. Overall, this review is designed to provide the fundamentals and recent advancements in different single-molecule techniques and their applications, with a special focus on the detection, manipulation, and control of single molecules on chip-scale devices.

Understanding the Social Determinants of Mental Health of Undergraduate Students in Bangladesh: Interview Study.

BACKGROUND: The undergraduate student population has been actively studied in digital mental health research. However, the existing literature primarily focuses on students from high-income nations, and undergraduates from limited-income nations remain understudied. OBJECTIVE: This study aims to identify the broader social determinants of mental health among undergraduate students in Bangladesh, a limited-income nation in South Asia; study the manifestation of these determinants in their day-to-day lives; and explore the feasibility of self-monitoring tools in helping them identify the specific factors or relationships that affect their mental health. METHODS: We conducted a 21-day study with 38 undergraduate students from 7 universities in Bangladesh. We conducted 2 semistructured interviews: one prestudy and one poststudy. During the 21-day study, participants used an Android app to self-report and self-monitor their mood after each phone conversation. The app prompted participants to report their mood after each phone conversation and provided graphs and charts so that the participants could independently review their mood and conversation patterns. RESULTS: Our results show that academics, family, job and economic condition, romantic relationship, and religion are the major social determinants of mental health among undergraduate students in Bangladesh. Our app helped the participants pinpoint the specific issues related to these factors, as the participants could review the pattern of their moods and emotions from past conversation history. Although our app does not provide any explicit recommendation, the participants took certain steps on their own to improve their mental health (eg, reduced the frequency of communication with certain persons). CONCLUSIONS: Although some of the factors (eg, academics) were reported in previous studies conducted in the Global North, this paper sheds light on some new issues (eg, extended family problems and religion) that are specific to the context of the Global South. Overall, the findings from this study would provide better insights for researchers to design better solutions to help the younger population from this part of the world.

ROS Live Cell Imaging During Neuronal Development.

Reactive oxygen species (ROS) are well-established signaling molecules, which are important in normal development, homeostasis, and physiology. Among the different ROS, hydrogen peroxide (H2O2) is best characterized with respect to roles in cellular signaling. H2O2 has been implicated during the development in several species. For example, a transient increase in H2O2 has been detected in zebrafish embryos during the first days following fertilization. Furthermore, depleting an important cellular H2O2 source, NADPH oxidase (NOX), impairs nervous system development such as the differentiation, axonal growth, and guidance of retinal ganglion cells (RGCs) both in vivo and in vitro. Here, we describe a method for imaging intracellular H2O2 levels in cultured zebrafish neurons and whole larvae during development using the genetically encoded H2O2-specific biosensor, roGFP2-Orp1. This probe can be transiently or stably expressed in zebrafish larvae. Furthermore, the ratiometric readout diminishes the probability of detecting artifacts due to differential gene expression or volume effects. First, we demonstrate how to isolate and culture RGCs derived from zebrafish embryos that transiently express roGFP2-Orp1. Then, we use whole larvae to monitor H2O2 levels at the tissue level. The sensor has been validated by the addition of H2O2. Additionally, this methodology could be used to measure H2O2 levels in specific cell types and tissues by generating transgenic animals with tissue-specific biosensor expression. As zebrafish facilitate genetic and developmental manipulations, the approach demonstrated here could serve as a pipeline to test the role of H2O2 during neuronal and general embryonic development in vertebrates.

Placental Production of Eicosanoids and Sphingolipids in Women Who Developed Preeclampsia on Low-Dose Aspirin.

Low-dose aspirin, which selectively inhibits thromboxane synthesis, is now standard of care for the prevention of preeclampsia in at risk women, but some women still develop preeclampsia despite an aspirin regimen. To explore the "aspirin failures," we undertook a comprehensive evaluation of placental lipids to determine if abnormalities in non-aspirin sensitive lipids might help explain why some women on low-dose aspirin develop preeclampsia. We studied placentas from women with normal pregnancies and women with preeclampsia. Placental villous explants were cultured and media analyzed by mass spectrometry for aspirin-sensitive and non-aspirin-sensitive lipids. In women who developed severe preeclampsia and delivered preterm, there were significant elevations in non-aspirin-sensitive lipids with biologic actions that could cause preeclampsia. There were significant increases in 15- and 20-hydroxyeicosatetraenoic acids and sphingolipids: D-e-C18:0 ceramide, D-e-C18:0 sphingomyelin, D-e-sphingosine-1-phosphate, and D-e-sphinganine-1-phosphate. With regard to lipids sensitive to aspirin, there was no difference in placental production of thromboxane or prostacyclin, but prostaglandins were lower. There was no difference for isoprostanes, but surprisingly, anti-inflammatory omega 3 and 6 PUFAs were increased. In total, 10 of 30 eicosanoids and 5 of 42 sphingolipids were abnormal in women with severe early onset preeclampsia. Lipid changes in women with mild preeclampsia who delivered at term were of lesser magnitude with few significant differences. The placenta produces many aspirin-sensitive and non-aspirin-sensitive lipids. Abnormalities in eicosanoids and sphingolipids not sensitive to aspirin might explain why some aspirin-treated women develop preeclampsia.

Protease Amplification of the Inflammatory Response Induced by Commensal Bacteria: Implications for Racial Disparity in Term and Preterm Birth.

Decidual macrophages secrete proteases that activate protease-activated receptor 1 (PAR-1). We hypothesized that activation of the inflammatory response by bacteria is amplified by proteases, initiating labor. In addition, we hypothesized that commensal bacteria trigger an inflammatory response by activating NF-κB and TET methylcytosine dioxygenase 2 (TET2), a DNA de-methylase, via a protease amplified PAR-1, RhoA kinase (ROCK) pathway. To evaluate these hypotheses, we compared responses of mononuclear cells with Lactobacillus crispatus, prevalent in the vaginal microbiome of women of European ancestry, with L. iners and Fusobacterium nucleatum, which are more prevalent in vaginal samples collected from African-American women. Decidual tissue was collected at term not-in-labor (TNL), term labor (TL), spontaneous preterm labor (sPTL), and infected preterm labor (iPTL) and immunostained for PAR-1, TET2, and CD14. Mononuclear cells and THP-1 macrophage cells were treated with bacteria and elastase, a known activator of PAR-1. The inflammatory response was monitored by confocal microscopy of TET2 and the p65 subunit of NF-κB, as well as IL-8 production. Decidual staining for PAR-1, TET2, and CD14 increased TNL < TL < sPTL < iPTL. All treatments stimulated translocation of TET2 and p65 from the cytosol to the nucleus and increased IL-8, but L. iners and F. nucleatum caused more robust responses than L. crispatus. Inhibition of PAR-1 or ROCK prevented TET2 and p65 nuclear translocalization and increases in IL-8. Our findings demonstrate that proteases amplify the inflammatory response to commensal bacteria. The more robust response to bacteria prevalent in African-American women may contribute to racial disparities in preterm birth.

Research on 5-fluorouracil as a drug carrier materials with its in vitro release properties on organic modified magadiite.

The magadiite (MAG) was modified by cetyltrimethyl ammonium-Bromide (CTAB) and then further modified by Chitosan (CS) which is called organic modified-magadiite as magadiite-cetyltrimethyl ammonium bromide (MAG-CTAB) and magadiite-cetyltrimethyl ammonium bromide-Chitosan (MAG-CTAB-CS), respectively, in this research study. The MAG, MAG-CTAB, and MAG-CTAB-CS were used as 5-Fluorouracil (5-FU) drug carrier materials; the drug carrier's materials were marked as magadiite-5-Fluorouracil (MAG/5-FU), magadiite-cetyltrimethyl ammonium bromide-5-Fluorouracil (MAG-CTAB/5-FU), and magadiite-cetyltrimethyl ammonium bromide-Chitosan (MAG-CTAB-CS/5-FU). X-ray diffraction(XRD, Flourier transform infrared spectrometry (FTIR) and scanning electron microscopy (SEM) results were shown that 5-Fluorouracil was combined with carrier materials through physical apparent adsorption, ion exchange, chemical bond, hydrogen bond, and electrostatic interaction. The drug carriers in vitro release behavior in simulated gastric fluids (SGF，pH = 1.35) and intestinal fluids (SIF，pH = 7.40) were investigated. The drug loading capacity and accumulated release ration were as follows the order: MAG-CTAB-CS/5-FU > MAG-CTAB/5-FU > MAG/5-FU. The drug loading capacity of MAG-CTAB-CS/5-FU was 162.29 mg/g, 48 h later the drug accumulated release ratio was 61.24%, and the release amount was 97.52 mg/g for 24 h. Korsmeyer-Peppas model and First order model were found to be suitable to describe the vitro release behavior of 5-Fluorouracil. This would be an economically viable and efficient method for the preparation of advanced drug delivery system.

Histomorphological pattern of renal biopsy in Dhaka: A single center study.

Renal biopsy is a useful procedure to understand the histological pattern of renal disease. We present the histomorphological characteristics of renal biopsy specimen received at histopathology department, Armed Forces Institute of Pathology, Dhaka received during July 2015 to December 2015 for six months period was included in the study.

Prediction of Thyroid Malignancies by Thyroid Auto Antibodies.

Thyroid cancer is the most frequent cancer among endocrine tumors, and account for approximately 1% of all malignancies. Recent literature has suggested an association between autoimmune thyroiditis and papillary thyroid cancer. The aim of the study was to choose the role of preoperative thyroid auto-antibodies as a predictive marker that could distinguish benign and malignant thyroid nodules and any other occult malignancy. This cross sectional study was done from July 2012 to June 2014 in department of Surgery Sir Salimullah Medical College & Mitford Hospital (SSMC&H) in collaboration with department of Otolaryngology SSMC&H, Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College and Bangladesh Medical College of Dhaka city. Inclusion criteria were all patients presenting with thyroid swelling. For this study, 116 patients of thyroid swelling were studied by detailed history, clinical examination, thyroid hormone assay (serum T3, T4, TSH), ultrasonogram to detect single or multiple nodules, solid or cystic condition of nodules, thyroid scan to see functional status of gland, FNAC to detect benign or malignant condition preoperatively, thyroid auto antibodies (Tg-Ab and TPO-Ab) and histopathological examinations. FNAC outcomes were compared with anti-thyroid auto antibodies (ATA) and histopathological reports. In this study it showed that out off 89 benign classes 53 were with raised and 36 were with normal anti-thyroid auto anti-bodies (Tg-Ab+TPO-Ab). Among the raised 53 patient only 14(26.41%) were proved malignant in histopathological examination. On the other hand out off 36 normal anti-thyroid auto anti-bodies (Tg-Ab+TPO-Ab), 5(13.88%) became malignant histopathologically. In the cytological malignant group out off 17 patient 8 (47.05%) were with normal anti-thyroid auto anti-bodies (Tg-Ab+TPO-Ab) and 09(52.95%) were with raised anti-thyroid auto anti-bodies (Tg-Ab+TPO-Ab) and all of them were histologically malignant. It was observed that FNAC with high level of anti-thyroid auto anti-bodies (Tg-Ab+TPO-Ab) will be suspicious for malignancy but not statistically significant in this study odds ratio for anti-thyroid auto anti-bodies (Tg-Ab+TPO-Ab) within normal and raised were 0.78(0.501-1.214) and 1.23(0.807-1.89) respectively. In the series sensitivity, specificity, positive predictive value and negative predictive value of thyroid auto antibodies and FNACs were done by the ROC curve. It showed that PPV was highest 96% for FNAC and for Tg-Ab and TPO-Ab it was 27% and 24% respectively. In this study thyroid auto-antibodies were raised in both benign and malignant conditions. TPO-Ab was more raised than Tg-Ab in our country with malignant conditions of thyroid. Thyroid auto anti-bodies could not predict the malignant condition of thyroid. In our study the benign cytology with raised antithyroid auto antibodies showed risk to be malignant outcome in histopathology.

Study on Electrophysiological Findings of Guillain Barre Syndrome Patients Attending the Department of Neurology in BSMMU.

Incidence and predominant subtype of Guillain Barre Syndrome (GBS) differ geographically. Electrophysiology has an important role in the early diagnosis and prediction of the prognosis. This study conducted to determine the predominant subtype of Guillain Barre Syndrome in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and to compare the nerve conduction study finding between the axonal and demyelinating form of GBS. To analyze the nerve conduction study findings of Guillain Barre Syndrome patients attending the department of Neurology in BSMMU. This observational, descriptive and cross sectional study was carried out in the department of Neurology, BSMMU, Dhaka from July 2014 to June 2016. Considering the inclusion and exclusion criteria, 50 patients recruited as the study population. Then after performing the nerve conduction study, patients classified into three groups: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN). Among the 50 patients that are finally included in the study; about 50%, 42%, 8% had the AIDP, AMAN and AMSAN variety of GBS respectively. Out of all patients, 64% were male and 34% were female. GBS was seen in a wide range of age (18-75 years). In AIDP, maximum clustering of the cases was seen in the elderly population and in the AMAN it was seen in the younger age group. Cerebrospinal fluid (CSF) analysis did not show any significant difference between the AIDP and AMAN variant of GBS. Distal latency prolonged in at least one nerve in all patients with AIDP. In axonal form of GBS (AMAN and AMSAN), the compound muscle action potential (CMAP) amplitude was 80% of the lower limit of the normal in at least two motor nerves. Prolonged F wave latency by >80% of the upper limit of the normal was seen in 40% of the AIDP patients. According to the nerve conduction study, finding- acute inflammatory demyelinating polyneuropathy (AIDP) is the predominant subtype. Although the electrophysiology and the CSF analysis are the important tools for the diagnosis of GBS, classification should not be making based on a distinct finding alone. If all the NCS parameters in multiple nerves tested after one week and within four weeks of onset of symptoms, definite diagnosis is possible in almost all the patients of Guillain Barre Syndrome.

H9N2 influenza viruses from Bangladesh: Transmission in chicken and New World quail.

The H9N2 influenza viruses that have become established in Bangladeshi live poultry markets possess five gene segments of the highly pathogenic H7N3 avian influenza virus. We assessed the replication, transmission, and disease potential of three H9N2 viruses in chickens and New World quail. Each virus replicated to high titers and transmitted by the airborne route to contacts in both species. Infected chickens showed no disease signs, and the viruses differed in their disease potential in New World quail. New World quail were more susceptible than chickens to H9N2 viruses and shed virus after airborne transmission for 10 days. Consequently, New World quail are a potential threat in the maintenance and spread of influenza virus in live poultry markets.

Relationships Between Physical Activity and Bone Density in People Living with HIV: Results from the SATURN-HIV Study.

We conducted a cross-sectional secondary analysis of baseline data from the SATURN-HIV study (N = 147; 78% male, 68% Black, median body mass index [BMI] 26.72 kg/m2, 13% with osteopenia, HIV-1 RNA < 1,000 copies/mL, stable antiretroviral therapy [ART]) to explore the relationship between physical activity (PA) and bone mineral density (BMD). We measured self-reported minutes of PA and BMD in the overall sample and subgroups based on national recommendations (≥150 minutes/week). Forty-one (28%) participants met recommended PA levels. Higher intensity PA was associated with higher BMD at the total hip (r = 0.27, p = .09; n = 41; 28%) and lumbar spine (r = 0.32, p < .05), and predicted higher BMD at the hip (p < .01; controlling for age, BMI, ART). Lumbar spine BMD did not retain significance in the regression model. Moderate-to-high intensity PA could prevent or mitigate excessive bone loss in people living with HIV.